We find that physicians entering Medicare (i.e., probably new docs) between 2009 and 2016 were WAY more likely to work in a large or hospital-owned practice, compared to physicians exiting (i.e., probably retiring) Medicare. (2/7)
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Our new @AnnalsofIM paper (w/@JMichaelMcW + @Michael_Chernew): patterns of turnover in the physician workforce likely contribute to provider consolidation. (1/7) https://annals.org/aim/article-abstract/2758850/physician-organization-role-workforce-turnover …
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For every physician who exited a large (50+ physicians) practice, 2.6 entered. For every physician who exited a hospital-owned practice, 2.8 entered. (3/7)pic.twitter.com/do0P6o6bdo
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Conversely, only 1 physician entered the smallest (1-2 physicians) practices, for every 3 who exited. (4/7)
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These patterns are particularly prominent in certain specialties: internal medicine, ophthalmology, neurology, and dermatology. (5/7)
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Why such different practice settings for entering/exiting physicians? Many possible reasons: rising admin costs of independent practice, pressure to bear risk, preference for flexible schedules, changing employment opportunities as providers consolidate, etc… (6/7)
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Findings suggest that mergers and acquisitions only tell part of the story re: drivers of consolidation in provider markets. To promote competition, we should figure out how to make independent practice more appealing. (7/7)
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Kraj razgovora
Novi razgovor -
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This is not difficult to understand - the burdens of the last decade’s EMR meaningful use as well as ACO’s driving consolidation resulting in higher reimbursement rates for hospital providers - disincentivized independent practice
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